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Permit (36) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 111 st ' COMMUNITY DEVELOPMENT Permit#: ELR2019-00058 TIC;A R f 7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2019 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9685 SW WASHINGTON SQUARE RD C07 Project: Casper Subdivision: None Lot: None Project Description: Limited energy for Audio,data,protective signaling,and CCTV,for TI. Contractor: ALLPHIN COMMUNICATIONS INC Owner: PPR WASHINGTON SQUARE LLC 23220 SW BOSKY DELL LANE PO BOX 847 WEST LINN, OR 97068 CARLSBAD, CA 92018 PHONE: 503-638-9000 PHONE: FAX: 503-638-9100 FEES Description Date Amount Specifics: Restricted Energy Permit 03/28/2019 $300.00 Type of Use: COM 12%State Surcharge-Electrical 03/28/2019 $36.00 Class of Work: ALT Total Number of Systems: 4 Audio&Stereo: 1 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 1 Fire Alarm: 0 HVAC: 0 Instrumentation: 0 Intercom/Paging: 0 Landscape/Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 1 Other: 1 Total $336.00 Other Desc: Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of is nce, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi on Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You y obtain a cop/•f the rules o rect questions to OUNC by calling 03. 32.1987 or 1.800.332.2344. —j Issued By: �T /A • Permittee Signature: ..‘" OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application I OR 01 I I( I, t s l: 0\1 l City of Tigard �`�5)-- Received /, :� 13125 SW Hall Blvd.,Tigard,OR 9743 Date/B : � ��� Dsd` Phone: 503.718.2439 , 9 g 2019 Plan Review Date/By: Related Permit#: 1� Il Email: TigardButldingPermits@Tigard-or.goJ ReadyDate/By: Juris: y See Page 2 for Inspection Line: 503 639 4175 Internet: www icditl�r►� otified/Method Supplemental Information 0 New construction p Addition/altera'17. _i• acement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories. � sit ';'''#t:--,0-- where the available fault current 0 Marinas and boatyards. }, ty ' °""' ' r ,n `" �t tik'11- . - exceeds 10000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural El Multi famllamps for all other installations. buildings. Y Master builder 0 Other: pump. Installation of ��1�� '���; e� , ['Fire um . 0 150 KVA or _,..- _. .AA 1. , ., i 7 , 1 f,, , r � F a .e �4 ❑Emergency system. larger separately derived Job#: Job site address: G�/�Q / ❑Addition of new motor load of system. {&i!5 ,N4 tt)lf al r�ct4Jv J 100HP or more. ❑«A» «E» «I 2» .<1 3„ Ci /State/ZIP: Por,,�• �Yot D 7 Z 2 3 J ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Pldg./apt.#: C p' Project name:(I 1\S ftp ❑Hazardous locations ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal Cross street/directions to job site: a a V li � 1 4�� � Description "x. ` Qty. Each Total 1*> New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 # s i; r r Ea.add'1500 sq.ft.or portion 33.92 1 '''';2:1:1 :':?:':-.;;!:(0-14, ` ._ -' "` : : l�' Limited energy,residential rl'i r`, ` 4 ' i ' Von ce-i) Q_.1 _ ,lam (with above sq. li 75.00 2 it r 1// e/ WC�I /Stti^� Limited energy,multi-family 5 2 /7 residential(with above sq.ft.) 7 00 w.`. 5{ � rF1A`I"( z .< .A �=a�r Renewable Energy 13 See Page 2 Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 : .,.,.s'fir + A f .... I lfr ,x ; ., ,„ Branch circuit SI:s alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, Contact name: each branch circuit 7.42 2 / B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Phone:( ) Miscellaneous(service or feeder not included) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 '.:,.. .. ,':::::-.'S',.=!.7,:::::-.:',- . . :lg# Og.:? ,g ;' . . . Pump or irrigation circle 67.84 2 Business name: Cif) t , A �1� (�h/l tMt1i✓a DNS Z/`n)L Sign or outline lighting 67.84 2 Address: a3�av C ,, {{ Signal circuit(s)or limited-energy �K// Y Oc� [.9• panel,alteration,or extension. Page 2 2 City/State/ZIP: A— Gf�� '�� Each additional inspection over allowable in any of the above ) 3 0 Additional inspection(1 hr min) 66.25/hr Phone:(503 1p _9 000 Investigation(1 hr min) 90.00/hr Email: C �'� �b�1 1� ee" r�a ork Industrial plant(1 hr min) 78.18/hr 1 N Inspections for which no fee is CCB Lic.: 0 Electrical : — ��?� s 90.00/hr I 7 5-, 4/04,61 Suprv.Lic.: pecifically listed(/�hr min Suprv.Electrician signature, L » )bt FEES P gnature,required: ` � Subtotal: Print name: e r y r��, 14(1411:4`_/ Date: /�c2 1/67 ❑Plan Review Required(25%ofpermit fee): ce v" it r/ (Jr State surcharge(12%of permit fee): Authorized signature: �/1 TOTAL PERMIT FEE: t!o et I-, i ld• t teht,„r Date: j a.ani days after it has been accepted as complete.This permit application expires if a permit is not obtained within 180 Print name: / * Number of inspections allowed per permit. I:\Building\Permits\ELC_Permitppp ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: n ,;,aeox Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 _© 5.01 to 15 kva in 133.56 _© • Audio and Stereo Systems* 15.01 to 25 kva - 200.34 _© Wind l eneration s stems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva III 301.04 _© 50.01 to 100 kva III 552.26 _© ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040 111. 552.26 —© ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 _© ❑ Vacuum Systems* >100 kva—no additional charge - 0.0 _© Each additional ins.ection over allowable in an of the above: ❑ Other: Each additional inspection is ■ 66.25/hr char led at an howl 1 hr min Inspections for which no fee is ■ 90.00/hr —. s.=ificall listed '/3 hr min Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): y s Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: E] Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems [Zi Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* Protective Signaling IN Other: 0 C-¶V Total number of commercial systems: -[ *No licenses are required. Licenses are required for all other installations I:\Budding\Permmits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9685 SW WASHINGTON SQUARE RD C07, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2019-00058 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9685 SW WASHINGTON SQUARE RD C07, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2019-00058 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor